Dearborn Academy Mental Health Initiative

Dearborn Academy

The fallout from the ongoing youth mental health crisis is overwhelming our national education and healthcare systems. The CDC’s Youth Risk Behavior Survey found that nearly all indicators of poor mental health, including suicidal thoughts and behaviors, increased from 2011 to 2021 across all racial and ethnic groups, with no foreseeable end in sight. A scarcity of providers and an overwhelmed mental health system add to the challenge, making it almost impossible for families facing complex and treatment-resistant mental illness to access appropriate care, shifting the burden to public schools, and sparking a contemporaneous crisis in special education. 

For children and adolescents experiencing symptoms of mental illness and often co-morbid learning disabilities, achieving academic potential and doing so with a positive and healthy sense of self are often seemingly unreachable goals. The most impacted individuals cannot obtain an education in a typical classroom setting, and they are ultimately placed in restrictive, out-of-district special education programs such as Dearborn Academy, sometimes at great cost and distance from their homes.

Difficulty accessing school compounds the diagnostic uncertainty families face while navigating two complex systems: mental health and special education. Students experience multiple transitions to new schools and specialized programs while struggling to access appropriate mental health supports, moving between providers, and being prescribed numerous psychotropic medications. These same students are also frequent visitors to emergency rooms for psychiatric evaluations. More recently, it has become increasingly common for private therapists to terminate care when students fail to make progress with treatment. The diagnostic odyssey of a typical Dearborn student spans years, often reaching an impasse in the absence of accurate diagnoses to explain their complicated collections of emotional disabilities, learning challenges, physical complaints, and mental health disorders. The result is treatment that is limited to symptom management. Years of acute worry, stress, and continuous advocacy for their children also take a toll on caregivers’ well-being.

Concurrently, there is a rapidly growing body of scientific evidence connecting infection, inflammation, immune dysregulation, and the development of neuropsychiatric symptoms like anxiety, depression, and OCD. The findings from these many recent studies serve to illustrate the point that common infections such as streptococcus, SARS CoV-2, influenza, Epstein-Barr Virus (EBV), bacterium Borrelia burgdorferi (Lyme Disease), and many others can trigger autoimmune disease, and specifically a family of rare immune-mediated neuropsychiatric disorders such as PANS (Pediatric Acute-Onset Neuropsychiatric Syndrome), PANDAS (Pediatric Autoimmune Disorder Associated with Streptococcal Infection), Acute Thyroiditis, Autoimmune Encephalitis, PASC (Post-acute sequelae of SARS-Cov-2 infection), and conditions linked to tick-borne illness. While these recent discoveries bring hope, the historic lack of fundamental knowledge around the relationship between physical and mental health has delayed advancements in care and perpetuated disparities and stigma for people suffering from mental illnesses. Youth and families struggling with complex mental illness associated with this group of rare diseases cannot wait years for bench science to translate to a cure. 

The Dearborn Academy Mental Health Initiative is a multifaceted effort to improve education and well-being for students with emotional disabilities and related learning challenges through diagnostic clarity, support for caregivers, and translational research. It's mission is to leverage the school’s growing clinical expertise and deepening knowledge of emerging science and research around immune-mediated neuropsychiatric disorders to ensure students and families at Dearborn Academy and beyond have the opportunity to find healing.

Dearborn Academy implemented an innovative diagnostic consultation service amid the pandemic with the goal of identifying the reasons why students were not making progress with their mental health. The protocol, known by families and staff as the Dearborn Academy Diagnostic Consult Model (DADCM), is a school-based system for ensuring students with complex learning and mental health challenges have accurate psychiatric and medical diagnoses to facilitate appropriate treatment and therapies both in and outside the school. The model draws on holistic concepts from education and health to fully understand the relationships between physical, mental, emotional, and social issues that impact a student’s well-being. 

The DADCM provides a cross-discipline roadmap for providers addressing behavioral health issues to fully consider the patients' mental health, medical, and education histories. It also facilitates clarification of mental health disorders through diagnostic screening tools and crucial medical rule-outs. The DSM 5 calls for full consideration of etiological medical conditions prior to diagnosing a mental health disorder. However, this step rarely includes a collaborative discussion between medical and mental health providers. The DADCM provides a fast-track to diagnostic clarity for students suffering from rare immune-mediated neuropsychiatric disorders.

DAMHI also includes support for caregivers and facilitates clinical research. Caregiver stress is one of the most prevalent and overlooked barriers to care for children and adolescents suffering from complex mental health and learning challenges, likely prolonging the diagnostic journey. This support is essential to 1. ensure all students accessing the DADCM complete the full protocol and 2. families feel confident consenting to participate in the research necessary to demonstrate the program's efficacy.

The consult team has also developed a new screening tool, the Gauch-Chapman Neuroimmune Psychiatric Screen [Provisional], to identify students likely to have a rare disease contributing to their neuropsychiatric symptoms. Once flagged, students can be referred for more in depth diagnostic evaluations. The screening tool was designed based on common traits among students who have benefited from the DADCM. The tool is simple and, once validated, could be utilized by clinicians in any setting, including public schools. 

The Dearborn Academy Diagnostic Consult Model and the Gauch-Chapman Neuroimmune Screen are innovative, accessible, and cost-effective diagnostic interventions. These key components of the DAMHI can be easily scaled once adopted as best clinical practice. The overarching goal is to disrupt the youth mental health crisis by advancing the fundamental knowledge around a host of underlying rare diseases complicating the situation. This solution aims to validate these diagnostic tools using empirical evidence collected via formal pilot studies conducted in Dearborn's novel school-based setting.

This solution aims to improve the lives of all people suffering from debilitating and treatment resistant mental illness. During the proposed pilot students at Dearborn Academy will receive the most direct benefit. The DADACM already significantly improves the diagnostic journey for students, and it changes the way students and families think about mental illness. 

Dearborn Academy serves special education students with emotional and learning disabilities from more than 25 school districts including Boston and the surrounding metro area. The diverse student body comprises the neediest and most marginalized children and adolescents from a broad range of cultural and socioeconomic backgrounds. Dearborn’s students, as well as their caregivers, have been repeatedly underserved, not well understood and ultimately forced to leave their public community schools.

Dearborn students have complex profiles and lengthy academic, mental health and medical histories. Their individual education plans (IEP) address special needs like: ADHD, Anxiety, OCD, Depression and Mood Disorders, PTSD, Language-based and Nonverbal Learning Disabilities (NVLD), Dyslexia, Writing and/or Comprehension Difficulties and Executive Functioning Challenges. Yet the profile of a Dearborn student suffering from a rare immune-mediated condition extends beyond the learning challenges routinely cited on IEPs.

Chronic absenteeism and school refusal are daily challenges, however mitigating suicide risk is the most arduous task. These students are frequently referred for emergency psychiatric evaluations and is not uncommon for students to have multiple hospitalizations related to self injurious behaviors, suicidal ideation, or attempts on their lives. 

Meanwhile, the number of public school students with similar needs qualifying for special education continues to rise. With an acceptance rate hovering around 5%, Dearborn Academy can't possibly meet the demand, even on a local level. Recognizing the exponential need, the DAMHI team seeks to validate, disseminate and scale their innovative diagnostic interventions improve the diagnostic journey and reduce stigma for this public school students across the United States and beyond.

Over 40 students utilized the DADCM between academic years 2020-2023. A complete in-depth analysis of the initial student cohort is pending; however, the majority of the students who completed the entire protocol received clarification regarding their mental health diagnoses and a recommendation to pursue follow-up testing and treatment for a suspected diagnosis of an immune-mediated neuropsychiatric disorder. Students and caregivers who accessed follow-up treatment overwhelmingly reported life-changing improvements in their health, while school staff observed leap strides with academic progress. The outcomes from the DADCM have been significant, and the school’s leadership has committed to streamlining the process so that school-based clinicians in other special education settings can utilize their model. 

The solution team has also created a screening tool, the Gauch-Chapman Neuroimmune Psychiatric Screen [Provisional], to help determine whether or not an immune-mediated neuropsychiatric disorder should be considered. The team is constantly updating and adjusting the tool based on clinical observations and outcomes from students accessing the DADCM. The prototype is now ready to be piloted, with an immediate goal of refining the proposed scoring methodology. A pilot of the Gauch-Chapman Neuroimmune Psychiatric Screen also has the potential to help expand the clinical diagnostic criteria for PANS/PANDAS and other immune-mediated neuropsychiatric disorders. 

The team’s ongoing work is critical to improving, validating, and scaling both the consult model (DADCM) and the screening tool. Preliminary outcomes already warrant further clinical investigation. 

The Dearborn Academy Mental Health Initiative (DAMHI) provides a novel setting for the clinical research needed to improve the diagnosis of rare immune-mediated neuropsychiatric disorders and advance treatment. 

DAMHI's first undertaking, the Dearborn Academy Diagnostic Consult Model (DADCM), eliminates barriers to care by bringing the clinical experts directly to their unique cohort of students and introducing a viable path to diagnostic clarity. The DADCM was created with the sole intention of helping students heal, but it is impossible to ignore the unexpected benefits to clinical research resulting from this work. These include:

• Unparalleled access to human subjects 
  • School clinicians have access to students ~30 hours per week
  • Volume of patient data
  • Higher integrity of subjective data
• Data obtained in the subjects' natural environment among peers
• Increased opportunity to establish trust with caregivers
• Continuity of care leading to improved outcomes for students
• Equitable access to providers
• Institutional affinity increasing likelihood of follow-up study participation

There is also little, if any, precedence for the school's use of a third-party institutional review board (IRB), but this course of action provides an ethical pathway for analyzing and disseminating findings to stakeholders outside the DAMHI. 

The DADCM let to the development of the Gauch-Chapman Neuroimmune Screen, which stands to make the largest direct impact on students. The tool has the potential to help educators and school-based clinicians screen for rare immune-mediated neuropsychiatric disorders in a public school setting, thereby expediting the diagnostic journey for those suffering in the dark. Schools routinely perform hearing and eye tests referring students to ophthalmologists and audiologists, but this would be the first screener of its kind for identifying rare diseases in a public school.

The DAMHI takes direct aim at rising needs in both special education and mental health. Budget constraints and special education teacher shortages are crippling public schools making it difficult for students to access services. The number of students accessing special education across the country increased from 13% to 15.2% over the last ten years and it is expected to continue rising. The CDC's Youth Risk Behavior Survey (YRBS) is even more troublesome. In 2021, nearly 30% of all high school students nationwide reported poor mental health and a shocking 21% considered attempting suicide. The DAMHI helps educators and mental health providers recognize that standard behavioral therapies alone do not improve outcomes for students with these rare diseases unless they simultaneously address the underlying root cause of their neuropsychiatric symptoms.

The DAMHI is uniquely suited to develop and disseminate cost-effective and accessible diagnostic interventions using empirical evidence and best clinical practice. Improving diagnostic protocols is a critical step towards the advancement of urgently needed targeted therapeutics. The pilot studies will provide natural history and epidemiological data urgently needed to advance research. Early detection and better understanding around the pathophysiology of this family of rare diseases could not only change the way we think about mental health, but also improve the trajectory of an entire generation.  

The Dearborn Academy Mental Health Initiative (DAMHI) has encountered many barriers to securing funding. The programmatic goals straddle multiple industries (education, medicine and mental health) and span numerous fields of expertise and specialization making it difficult to identify clear pathways to funding. 

The medical community has been slow to embrace diagnoses for immune-mediated neuropsychiatric disorders. One contributing factor is likely western medicine's siloed approach to healthcare. Providers treating neuropsychiatric disorders are board certified in various specialties including, psychiatry, rheumatology, infectious disease, neurology, gastroenterology and others with no clear home in the medical community. The bias generated from these silos hampers research and development. NIH funding has been extremely limited. For example, between 2013-2023 the NIH funded only 3 PANS/PANDAS investigators for a nominal investment of less than $9 million dollars, with most of the research conducted on the same 400 aging samples collected nearly 25 years ago. By comparison, the NIH invested $939 million dollars in cystic fibrosis research during this same time period. 

Legislators have been a beacon of hope for advocacy groups passing bills that force insurance companies to cover the cost of treatment, but the bills don't mandate coverage for the exorbitant costs associated with the diagnostic journey. Few, if any, training programs exist to address the critical shortage of treaters. Provider burnout is also a major challenge. Unmanageable case loads, poorly defined treatment protocols, traumatized caregivers, and insufficient reimbursement structures deter young healthcare professionals from pursuing a career devoted to this vulnerable population. Many of the existing providers no longer accept insurance and those that do have established strict criteria for accepting new patients in an effort control for the demand. 

This all leads to significant racial and socioeconomic disparity in spite of clear evidence that all races and ethnicities are affected. One harmful study concluded that 100% of PANS/PANDAS cases were non-hispanic caucasians. People suffering from Chronic Lyme Disease and other tick-born illnesses report similar difficulties. Limited mainstream treatment options force many families to rely on costly alternative medicine. Caregivers are also negatively impacted, impeding their ability to find knowledgable providers.

The biotechnology and pharmaceutical industries, which have produced miracles for so many in the rare disease community, have also been reluctant to invest resources in immune-mediated neuropsychiatric disorders. An absence of biomarkers combined with insufficient natural history and diagnostic criteria limits their ability to develop and obtain FDA approval for targeted therapies.

Meanwhile, RFPs related to Education and Mental Health are overwhelmingly directed at increasing access for behavioral health services, and the concept of clinical research in a school-based setting is too far outside their normal comfort zones.

The Amgen Prize will enable the DAMHI team to generate evidence demonstrating the value of the its current work, as well as its potential to improve the diagnostic journey for all people suffering from rare immune-mediated neuropsychiatric disorders. The Amgen Prize offers the DAMHI team the freedom required to maximize impact and reach stakeholders across multiple industries, specialties and disciplines.

The entire staff at Dearborn Academy is dedicated to helping students with complex mental illness and related learning challenges find healing. Head of School, Rebecca Altepeter, has prioritized improving the health and wellbeing of students and their caregivers, which has proven both effective and more equitable for families. These guiding principles are what inspired the implementation of the Dearborn Academy Mental Health Initiative (DAMHI) and pursuit of scalability and research opportunities. 

The DAMHI is led by Principal & Clinical Director, Sheilah Gauch and expert consultant Margaret (Peggy) Chapman, Clinical Nurse Specialist in Child and Adolescent Psychiatric Nursing. They are joined by Head of School, Rebecca Altepeter, the School Nurse, Alyssa Coneys and an Independent Research Director, Mary Sparks who brings unique knowledge and perspective spanning healthcare, start-up and education with specific expertise in clinical research and special education. 

Sheilah Gauch and Peggy Chapman are respected pioneers in the rare disease field of immune-mediated neuropsychiatric disorders. Sheilah Gauch serves on the Board of Directors for both the The Alex Manfull Fund (TAMF) and Look Foundation and she is a founding member of the National Alliance for PANS/PANDAS Action (NAPPA). She recently co-led the Massachusetts Coalition for PANDAS/PANS Legislation spearheading support for two separate groundbreaking bills. The first bill, H.3920 is a historical piece of legislation seeking to ensure that all medical and clinical settings implement appropriate screening for rare diseases like PANS and PANDAS. The second bill S.1266/H.1975 mandates the Department of Mental Health and the Department of Education conduct a joint study to determine the number of children and adolescents in costly inpatient psychiatric hospitals and therapeutic day schools suffering from undetected neuropsychiatric disorders. 

Sheilah Gauch is well positioned to train both educators and behavioral health providers on the use of the diagnostic interventions developed through the Dearborn Academy Mental Health Initiative. She is already an approved trainer for the Massachusetts Partnership for Youth and the commonwealth's Departments of Mental Health and Public Health. She is a frequent speaker on subjects impacting young people in the rare disease community such as school avoidance and caregiver trauma. Her speaking engagements include conferences for organizations like the International Network for School Attendance (INSA) and International OCD Foundation (IOCDF) and she is an invited contributor to Psychology Today. Most importantly, Sheilah brings a unique perspective, not only as an educator and social worker, but as the parent and caregiver of two young adults whose childhoods were disrupted by undetected rare immune-mediated neuropsychiatric disorders.

Expert consultant, Peggy Chapman, brings more than 40 years of experience treating neuroimmune disorders. Peggy just opened the PANS Center where she treats children and adolescents with this type of rare disease. Her goal is to model best practice and create a viable career path for young health professionals. 

Everyone on the solution team goes well beyond the scope of their job descriptions and paid duties to conduct research, pursue opportunities for funding and to expand the teams' network of collaborators across industries, specialties and disciplines.

Short-term impact goal: The DAMHI will improve the diagnostic journey for every student suffering from treatment-resistant complex mental illness enrolled at Dearborn Academy. 

• The team will validate the Gauch-Chapman Neuroimmune Screen.
  • The team will administer the screener before and after a student accesses the DADCM Protocol and record results to determine an appropriate scoring system.
• The team will validate the Dearborn Academy Diagnostic Consult Model (DADCM). 
  • Upon completion of the DADCM protocol the team will review student data and identify 1. how many students had changes to their mental health diagnoses and 2. how many student received a recommendation to seek follow-up care for a suspected immune-mediated neuropsychiatric disorder. 
  • For students who obtain follow-up treatment, the team will compare the following metrics before and after the diagnostic intervention: Number of School Absences, Number of ER Visits for Psychiatric Evaluations, Number of Psychiatric Hospitalizations, Occurrence of Self-Injurious Behaviors, Occurrence of Suicidal Ideation, Number of Suicide Attempts, Successful transition to Less Restrictive Learning Environment (Y/N)

Long Term Impact Goals:

1. The Gauch-Chapman screener will be widely used by educators and behavioral health specialists helping more people find diagnostic clarity.

• Number of unique visits to open source digital screener.

2. The DADCM protocol will be implemented in other restrictive special education programs reducing costs for out-of-district placements related to treatment-resistant mental illness.

• The number of special education programs that using the DADCM protocol.

3. The DADCM protocol will be modified as a clinical diagnostic protocol to improve the diagnostic journey for patients exhibiting acute self-injurious behaviors and suicidal ideation in tertiary care settings.

• Existence of widely available open source clinical diagnostic tool
• Reduced recidivism for hospitalization of self-injurious and suicidal patients    

4. The DAMHI will improve understanding around the pathophysiology of rare immune-mediated neuropsychiatric disorders.

• Number of IRB approved research studies involving Dearborn Students
• Number of publications citing DAMHI data or new data collected using the DADCM or Gauch-Chapman Neuroimmune Screen.

The solution team will accomplish these goals primarily through peer reviewed peer-reviewed publications in scientific journals. The team will also present their work at national professional conferences for educators and healthcare providers.

Specific publication goals include: 

1. The team will publish a retrospective study including case studies of the preliminary impact the DADCM protocol. 

2. The team will publish the Gauch-Chapman screener and methodology in a peer-reviewed scientific journal.

3. The team will publish the DADCM protocol along with empirical data to support its positive impact on the diagnostic journey for students suffering from immune-mediated neuropsychiatric disorders.

The staff at Dearborn Academy are dedicated to helping students heal. It is widely accepted that education leads to better health outcomes throughout life. At Dearborn Academy the emphasis on both clinical and academic success allows staff to explore the less understood reverse causality, which is that poor health, and specifically chronic mental illness, impedes access to education. As a therapeutic day school, Dearborn Academy's theory of change resides on the idea that improving diagnostic clarity for students with treatment-resistant mental illness can lead to better academic outcomes.

The federal Individuals with Disabilities Education Act (IDEA) mandates that school districts offer all students a free appropriate public education (FAPE) in the least restrictive environment (LRE), which includes special education and related services for eligible students with disabilities. When a student’s needs exceed the resources and support that the public school can provide, the district may recommend an alternative learning environment, such as Dearborn Academy, at no cost to the student or their family. The tuition and transportation costs associated with out-of-district placements are paid by local school districts. In 2024-25 the tuition at Dearborn Academy will be XXXX. 

When a student accessing special education makes effective progress commensurate with their individual learning potential they no longer require as much support. This means they can return to a less restrictive and less expensive educational setting. The best case scenario means students can return to the public school in their home community, or if they graduate from Dearborn, are able to access higher education. 

The team has already helped identify more than 30 students with underlying infections and rare immune-mediated or autoimmune conditions that, once found, enabled them to pursue appropriate treatment and begin healing in ways previously unseen by Dearborn's clinicians. However, the most compelling proof that these diagnostic interventions are not only changing, but also saving, lives are the numerous stories from students and their caregivers who were able to find the root cause of their symptoms and access treatment. Veteran caregivers whose students have benefited from the consult model offer testimonials like:

"We sought professional consultations and he was misunderstood and inaccurately labeled with a slew of incorrect ‘diagnoses’" - Caregiver

"I just wish it hadn't taken 5 years to find help." - Caregiver

"She feels better knowing [that] there are reasons behind what she's been feeling, and we can treat it" - Caregiver

One former student eager to help others offered a detailed testimonial about how the clinicians at Dearborn Academy helped her get diagnosed and successfully treated for the rare disease known as PANDAS. Click HERE to read Nicole's full story.

The development and dissemination of empirically backed diagnostic tools and protocols can expand the team's impact far beyond Dearborn Academy. Wide spread adoption of DAMHI's diagnostic interventions will reduce cost and create better outcomes across special education programs and other clinical settings, and in the long term improve the way our society views, treats and cares for people suffering from mental illness. 

The Solution Team consists of 5 people and includes everyone involved with the Dearborn Academy Mental Health Initiative.

Full-time staff at Dearborn Academy:

• Rebecca Altepeter, MS Head of School

• Sheilah Gauch, LICSW, M.Ed., Principal & Clinical Director

• Alyssa Coneys, MSN, RN, CPNP-PC, School Nurse

Consultants:

• Margaret (Peggy) Chapman, PCNS, Clinical Nurse Specialist in Child & Adolescent Psychiatry

• Mary Sparks, Research Director

We started planning in 2019, and implemented the consultation service in 2020.

At Dearborn Academy Diversity + Equity + Inclusion = Belonging, and belonging is central to the healing process. The staff at Dearborn Academy go above and beyond to make all students feel comfortable to be themselves and model adults engaging in courageous conversations about diversity, equity and inclusion. Students must see representation in the staff and student body, in the visual objects displayed around the school, and in the curricula. The intentionally diverse student body is 25% BIPOC/Latinx and consists of 47% males, 41% females and 11% non binary students.  24% of the staff and 17% of the leadership team identify as BIPOC/Latinx.

Dearborn is proud to have a dedicated team of volunteers engaged in weekly DEI meetings, and they are a valuable resource to the solution team. The entire staff team has benefited from the consultation and training from experts in the field regarding the critical issues that include recognizing and responding to microaggressions; hiring and retaining staff of color; understanding the needs of many LGBTQIA++ individuals; and expanding our already extensive use of restorative practices to better reach students with disabilities. 

Supporting caregivers is also critical to Dearborn's DEIB strategy. Caregiver stress is among the most prevalent and overlooked barriers to clinical care, and subsequently participation in related research. Addressing caregiver trauma is a key component of the Dearborn Academy Mental Health Initiative.

“As a parent, to not be alone is the biggest resource possible. All of us have felt ‘outsidedness’”. - Former Dearborn Parent

Furthermore, the Dearborn Academy Mental Health Initiative provides an organically diverse pool of human subjects to conduct research and advance the diagnosis and treatment of rare diseases that trigger immune-mediated neuropsychiatric symptoms. Centers of Excellence are limited to subjects who are actively seeking a cure. People suffering from this type of rare disease, as well as their caregivers, are often too compromised to overcome systemic barriers to appropriate care. The Dearborn Academy Mental Health Initiative is designed to remove all barriers to care for students and families including, cost, language, discrimination and bias, transportation, provider shortages and long wait times for appointments. 

This solution aims to illustrate that clinical research conducted in the subjects' natural environment leads to better DEI outcomes.

The Dearborn Academy Mental Health Initiative helps special education students with complex mental illness and related learning challenges find healing through diagnostic clarity in a novel school-based setting. The Dearborn Academy Mental Health Initiative changes the way society views, treats and cares for people with debilitating mental illness.

Diagnostic clarity helps students access appropriate treatment, so they can make academic progress commensurate with their full learning potential and continue their education in a less restrictive environment such as the public school in their community of residence. Dearborn's innovative diagnostic tools offer students equitable and affordable access to the latest medical and scientific advancements. Most importantly, the Dearborn initiative affords students and caregivers the opportunity to realize a happy and healthy future beyond symptom management.

The Dearborn Academy Mental Health Initiative's three pronged approach uses diagnostic clarity, caregiver support and research to mitigate the youth mental health crisis that is plaguing our national education and healthcare systems. Key stakeholders include: students, caregivers, public schools, special educators, behavioral health providers, third-party health insurers, and scientists. Expediting the diagnostic journey for this vulnerable population reduces special education spending for local school districts and reduces healthcare costs for third-party payers and out-of-pocket expenses for families. Diagnostic clarity is the key to reducing recidivism to emergency departments and in-patient units for psychiatric emergencies. The holistic approach encourages behavioral health providers to support the whole patient or student, which includes wrap-around support for caregivers. Finally, the initiative is designed to give back and help others by way of generating natural history and epidemiological data critical to future scientific advancements.

The team will reach stakeholders primarily through professional development via government agencies, membership associations and peer-reviewed scientific publications. The team is already making in-roads across specialties and industries. Team lead, Sheilah Gauch, provides numerous trainings for state agencies in Massachusetts including the Department of Mental Health (DMH) and the Department of Public Health (DPH), and the Massachusetts Partnership for Youth which offers professional development to educators state-wide. Team members have established relationships with the School Nurses Association and the Neuropsychology and Education Services for Children and Adolescents (NESCA) which supports neuropsychologists. Team members also collaborate with non-profit organizations dedicated to patient advocacy for the rare diseases impacting large numbers of students at Dearborn Academy including: The Look Foundation, The Alex Manfull Fund, EXPAND, Mending Minds, The Louisa Adelynn Johnson Fund and others. Finally, the entire team is actively involved in legislative advocacy efforts that will direct government resources to support their work. Additionally the team is actively seeking grant funding to leverage the health data that they have already collected and advance knowledge and understanding around the pathophysiology of rare immune-mediated neuropsychiatric disorders. 

The team's expansive and growing network provides credibility to the Dearborn Academy Mental Health Initiative and will help secure funding to validate and disseminate it's innovative diagnostic tools: Gauch-Chapman Neuroimmune Screen and the Dearborn Academy Diagnostic Consult Model.

The Dearborn Academy Mental Health Initiative currently relies on an embedded business model to cover the cost of caring for students and supporting their caregivers. Local school districts pay student's tuition, which in turn covers all education related expenses. Students rely on their individual health insurance to cover medical expenses incurred for routine laboratory testing and follow-up treatment when indicated. Supplemental funding could expand the Dearborn Academy Diagnostic Consult Model protocol to include cutting edge diagnostic testing that is generally not covered by insurance.

Supplemental funding is necessary in order for the team to conduct activities related to clinical research and dissemination of their work. The proposed integrated model would include grant support to pay for expenses research activities. Presently, full time employees at the school do not receive any compensation for their efforts developing the clinical diagnostic interventions. This includes the Principal/Clinical Director, Head-of-School, and the School Nurse who all work countless hours, mostly during evening, weekends and vacations to refine their practice in an effort to help students beyond Dearborn Academy. Although admirable, this practice is not sustainable. The team also needs supplemental funding to retain the services of a biostatistician and/or an experienced medical writer to assist with submission of peer-reviewed scientific publications. 

Once the team has successfully validated their clinical diagnostic tools, they will turn their attention to generating external funding for dissemination. Team leader, Sheilah Gauch, is already in high demand to provide trainings on a variety of topics related to best clinical practice for patients and students suffering from complex mental illness. The business plan is to develop professional development courses that train school administrators how to implement the Dearborn Academy Diagnostic Consult Model in appropriate special education settings and to train behavioral health providers why and how to use the Gauch-Chapman Neuroimmune Screen in any clinical setting. Participants will receive credits for their respective fields in the form of both PDPs and CEUs. Registration fees will ultimately generate a critical revenue stream and offset costs associated with this work, but supplemental funds are needed in order to cover the cost of developing the courses.